1999 Abortion Statistics Just Released
Follow the money, watch for fraud, but don't follow the patient's health
By Jakki Jeffs

Induced abortion is the most frequently performed, publicly funded surgery in Canada. Statistics Canada has indicated that one woman in three will have an abortion in her lifetime. One would expect that provinces would be compelled to provide comprehensive statistics in order to study the impact of abortion on fertility and sterility; to assess post abortion trauma, long-term psychological, physical and emotional complications; and to establish or debunk the link between induced abortion and risk of breast cancer. (Currently, 28 of 33 studies show a significant, increased risk.)

However, the demographic statistics provided over the last few years have continued to shrink, until finally, out of a total of 65,662 records in the database for 1999 (exclusive of Ontario statistics), there are only detailed records for 29,016 (44.2%)! The total number of induced abortions performed in Canadian hospitals was 41,483 with detailed records provided for only 24,524 (59.1%). The total number of induced abortions performed in Canadian clinics was 24,179 with detailed records available for only 4,492 (18.6%). How can we possibly assess the safety of induced abortion, understand its impact on our society, or begin to help women dealing with crisis pregnancy if provinces are not federally required to ensure these demographic statistics are reported by all facilities which perform induced abortion?

We have to thank Lyn Smith and Action Life (Ottawa) for being the watchdog in Canada. They have noted the continuing demise of demographic information for several years, and challenged our Minister responsible for Statistics more than once to ensure that these numbers are not only kept, but improved. In her 1996 report entitled "Canadian Abortion Statistics and Statistics Canada Health Division," Lyn set out the background for the collection of abortion data in Canada. I believe this paper remains a collection of invaluable information and would suggest that it be made available to every pro-life group in Canada.

Lyn noted in 1986 and 1995 that statisticians at Statistics Canada agreed that it was the mandate of Statistics Canada to compile and publish relevant information in an impartial, objective, and professional manner which would enhance debate and decision-making on important social and economic issues in Canada. In 1970, therapeutic information data was collected for the first time. Provinces informally requested hospitals and then clinics to fill out a "Report on Therapeutic Abortions" form which required quite comprehensive demographic information. (This form is not the one which is filled in by the facility to obtain the OHIP or applicable provincial coverage reimbursement.) Since 1988 when Canada's abortion law was struck down, hospitals have been less and less likely to take the time to fill out this form, and in fact, many clinics have refused the invitation to fill out this form and have never provided demographic information. The 1999 statistics bear this out with detailed records available for only 18.6% of the total number of abortions performed in clinics (24,524), representing 37.5% of the total number of abortions performed in Canada.

Lesson Learned

My research has taught me a valuable lesson: the statistics which our provincial Ministry of Health departments require to be collected are necessary in the sense of preventing fraud only. For example, if a person had an appendectomy in 1999 and then a form was filled out for another appendectomy in 2001 for this same individual, the MOH records would send up a flag. It would be investigated and, hopefully, a "fraud" prevented. The Ministry follows the money, not necessarily the patient's health. The form for provincial insurance coverage is a mandatory requirement but the "Report on Therapeutic Abortions" form is an invitational aside which, as Lyn Smith has pointed out, is gradually being ignored. This is where the real problem lies.

Ontario refuses to co-operate

In 1994, Alliance for Life Ontario was refused the listing outlining hospitals and clinics performing abortions in Ontario, including the total number at each facility. Despite two appeals to the Freedom of Information office, we were denied this data, and in 1995 were refused any further demographic information for Ontario abortion statistics.We had been receiving comprehensive data for five years prior to this situation.

In 1996, the Canadian Institute for Health Information took over the collection of therapeutic abortion statistics, and we have received less and less detailed reports since that time. In May of 1999, Action Life (Ottawa), with the support of MP Tom Wappel, again challenged Statistics Canada to release the 1996 and 1997 national statistics, but Ontario failed to comply by not reporting-stating a fear that providing the information could contribute to violence aimed at abortion providers. Ontario eventually complied and statistics were released in 1999.

Finally, this January, 2002, the Ontario statistics were omitted from the latest Canadian abortion figures for 1999. Investigation produced different responses from Statistics Canada, the Canadian Institute for Health Information (CIHI) and the Ontario Ministry of Health and Long-term Care (MOHLTC).

According to John Letherby, Media Relations Co-ordinator of the Ontario MOHLTC, "Ontario abortion statistics are the sum of abortions done in hospitals plus the abortions done in Independent Health Facilities (clinics). [CIHI] reports statistics on behalf of Ontario. MOHLTC provided CIHI with the total number of abortions performed in IHF clinics in 1999 [hospitals report straight to CIHI]. CIHI compiled the Ontario statistics for 1999 abortions performed in Ontario hospitals and provided that to Statistics Canada. Statistics Canada determined for scientific/statistical reasons not to report the 1999 Ontario statistics. MOHLTC is working with Statistics Canada and CIHI to resolve reporting and data irregularities within the 1999 abortion data."

Is this any clearer for anyone?

What the 1999 statistics tell us

•  37.5% of induced abortions were performed in clinics (24,524).

•  63.2% of induced abortions were performed in hospitals (41,483).

•  231 Canadian women underwent legal abortions in the U.S.

•  9,043 girls aged between 10-19 years had abortions in hospitals.

•  5,223 girls between 10-19 years had abortions in clinics.

•  60% of the women who had abortions in 1999 were not married, with a figure of 29.5% reported as "unknown status."

•  50.5% of women undergoing abortion had no previous deliveries.

•  Number who had at least one delivery has grown to its largest ever percentage-38% in 1985, 48.9% in 1998, and 49.4% in 1999.

•  The number of repeat abortions in 1999 (37.1%) was almost the same as 1998 (37.4%).

•  There were 31.8 abortions per 100 live births.

Since hospitals and clinics only filled out detailed information for 44.2% of the induced abortions performed in Canada, plus the fact

that Ontario's figures (which in 1998 totalled 38.7% of all Canadian abortions) are absent for 1999, it remains extremely difficult to draw a conclusive picture of the situation. The fact is, we have almost 40% of all 1999 abortions unreported and no detailed information on 54.8% of those that were reported. This situation must not be tolerated!

A very misleading statistic is the complication rate. This statistic is recorded during the duration of the woman's stay at the hospital or clinic that performs her abortion. If a complication arises once she leaves, it is not connected to her abortion.

What we need to do

Our provincial Ministry of Health departments have no short or long term reporting requirements for induced abortion. Remember, they only follow the money. As an educational movement, we need to make a case to our federal health department to insist that, as well as filling out the required insurance form, provinces mandate their abortion facilities to fill in the "Report on Therapeutic Abortions" form which traditionally has been used to obtain detailed demographics.

I would suggest that a committee be set up to investigate, research, collect and compile available data which can be used to encourage our government to demand compliance from abortion facilities to make the detailed reports. I have it on good authority that the information is available for Ontario, but the woman who has done this job, by hand, has retired. The forms are there with the information, but we must produce the political will to do the work.?

For more abortion statistics see

www.statcan.ca

Jakki Jeffs is Executive Director of Alliance for Life Ontario and has done extensive work in the past on abortion statistics .